Mechanism for angular adjustment of surgical pin and nail directing apparatus in a vertical plane



Aug. 15, 1950 M; F. STEPHENS 2,519,003

MECHANISM FOR ANQULAR ADJUSTMENT 0F SURGICAL PIN AND NAIL DIRECTING APPARATUS IN A VERTICAL PLANE Original Filed Jan. 22, 1945 3 m Mar/"00 7. 5730/26/75 Patented Aug. 15, 1950 MECHANISM FOR ANGULAR ADJUSTMENT OF SURGICAL PIN AND NAIL DIRECTING APPARATUS IN A VERTICAL PLANE Mari on F. Stephens, Sullivan, Ind., assignor to corporation of Illinois Original application January 22,1945, Serial No.

573,954. Divided and this application 14, 1948, Serial N0. 54,425 i 5 Claims. (01. 128-92) This'inventionrelates to mechanism for angulaifa'djustmentof surgical pin and nail directing apparatusin' a vertical plane, and comprises a division of my co-pending application Serial No. 573,954 entitled Post Adjusting Means for Wire and Nail Directing Apparatus, filed January 22, 1945 and now Patent No. 2,454,680, granted November 23,1948.

As conducive toa invention it maybe pointed out that in the extensivei practice of hip nailing, there has been developed what is called the Smith-Peterson techniquem It comprises the insertionflof a guiding pinfor wire inthe shaft of the femur, the. wire serving tofguide a cannulated vitallium Smith- Peterson nail inserted in such a manner'that it parallels and isin contact. with the medial and anterior cortex oi the neck of v the femur. The guide, commonly called a Steinmann pin, is usually about three-thirty-seconds of an inch by ten inches and is removed from the bore of the nail after the latter has been properly positioned hithe fracturedneck of the femur. The smith- Feterson' nail for an adult is about five inches longand has a diameter, of fiVe-thirtyseconds of an inch although it is flanged and generally triangular in cross-section. It extends through a hole drilled in the hard outer portion of the femur, the hole extending in line with the center of'theacetabuluni at approximately 20 anterior angle. The nail extends through the neck and preferably into the head orball-like portion of the hip joint, and'its functionisof course to reenforce the head on .the-neckof the femur. For the-bestresults, the nail must he nearly. in the direct weight-bearing line of the joint and so positioned that it receives thesupport of the dn'secorticle bone on both sides of the distal fragment. The insertion of both the guide pin and the nail must be controlled at allstages by two-plane radiography and in the past the successful placement of such fixation devices has clearer understanding of this .A primary object: of

relationship of mechanism comprising the 'independed largely upon the senses of sight and touch of the surgeon and has required a high d'gr e e'of skill. "As will be readily apparent various types of adjustment are needed for an apparatus of this character.v Suitable means for rotaryangular adjustment of the apparatus in a horizontal plane are described in my above mentioned patent.-*

The Guidoscopc Corporation, Chicago, 111., at

October 2 V We the instant invention is: the provision of mechanism for angular adjust: 1' ment in a vertical plane of the pin or nail guide ofsuch a surgical instrument. I

Another object is to provide an adjustable sup- 1 port for the nail guide which may be quickly set in an approximate adjustment and then further moved to obtaina finer adjustment. 4 ,The invention resides in the combinations of elements, arrangements of parts, and features". of construction, all as will be more fully pointed, out in the accompanying drawing wherein there"; is disclosed apreferred embodiment of this ini ventiveconcept. In the drawings: i Fig. 1-is a sideelevational view of one form of.' device embodying the features of the present invention.

Fig.- 2 is an end elevational view of the con-I.- struction of Fig. l, as viewed from the right. *Fig. 3 is afragmentary view of a portion of s Fig. l as viewed from the opposite side.

Fig. 4 is an enlarged sectional view. taken substantially along the line 44 of Fig. 2 as viewed in the direction indicated by thearrows.

Fig. 5 is anenlarged detail sectional view taken substantially along the line 55 of. Fig. 2 as viewed in thedirection indicated by the arrows,

and.

Fig. 611s a reduced schematic viewshowing the stant'invention with other portions of the app'aratus. G f." Similar reference charactersrefer to similar parts throughout the several views of the V drawing-p i Referring now tothe" drawings-in detail and. particularly to Fig. 6, the apparatus or instrument comprises a base'plate generally indicated -"at I ll supporting a tubular member ll within such, for example, as that set forth in my application Serial No. 54,424 filed concurrently h re;

with andentitled Mechanism for Vertical Ad justm'ent .of Surgical Pin and Nail Directing Apparatus. Rotary adjustment of the post is 7 provided by means of a spider. including an L operating nut l5 as disclosed in the above mentioned patent. I

Referring now to the apparatus of the instant invention in detail, the upright post I2 is formed with a reduced and squared portion I5, the upper extremity of which is bifurcated to form bearing ears or brackets I6 (see Fig. 2). A shaft l9 having a square or fiat-faced intermediate portion is'rotatably mounted in said ears by providing them with bearing openings to receive cylindrical journal portions I1 and I8 formed at the ends of the squared portion. A depending shank 2t ears l6 and has at its lower end a square or fiatformecl on a transversely extending uide for a; surgical pin, nail, drill or the'li'ke' fits between: faced notch to engage shaft l9 as seen in Fig". 5. Shank 2| is preferably secured; to. theshafh by a screw 2! which when removed permitsthe guide to be readily lifted off of the shaft.

The guide 22 is an elongated; body extending transversely above the post and; F 315 in its topav V-shaped groove in which may be clamped a nut or the like by an inverted U-shaped spring clip or other means. These parts form no part of the present invention and are claimed in my application Serial No. 54,426 filed concurrently herewitlr and entitled P-in Guide-and Securing Means f or Surgical Nail and Pin Directing Apparatus.

It will be seen that when shaft [9 11s turned the nail guide will; be angled in a vertical plane, I provide means forindicating the angular adjust? nfent of the guide and also means for permittingfirst a quick and approximate adjustment of it" and then a finer'adjustr-nen-t. Between the shaft and the post I provide protraction means for indicating the adjustment. Prefera'bi y'a protrac-- tor plate; 2'? has a hub portion- 26 witha squared opening to receive a squared portion 25 form on?" a portion of shaft I9 which extendsbey ond the journal portion I8. A nut 28 screwed on a reduced threaded extremity 29 of the s-haft'may be used to fasten the protractortcr the shaft. The graduations on the pro-tractor coact withafixed mark. 3.3 which is preferably on an arcuate plate 3i fastened by screws 32 to the post, as seen in Fig. 3'. It is obvious theta Vernier-may be used in place of parts 3%, 33. i

l'I'he means for moving the shaft to obtain a firle' adjustment after an ap roximate adjustment has been made andto lock th shaft agm'nst'turn lug, preferably located at the other end of the shaft and is associated: with the; journal portion? H"; The latter; as seen in Fig. f, extends beyond the associated ear or bracket IS and has rotatabl-y" clamped upon it a collar or hub 35 carrying a flat and downwardly projecting radial arrn 4 h Arr internally threaded boss 36 on hub 35 carriesa set screw 31 with a milled head 38. A cap crewthreaded in a socketinthe end of" the shaft retains the hub thereon.- When screw-Wisturned' in one direction it locks the arm to turn the shaft. The a-rm M is actuated and then: locked by; apair of axially aligned screws 421 provided at their outer ends: with. milled heads 43: and: having their inner ends engageable with. the: opposite sides; or faces. of arm 41 as shown: El a.- l:- Screws 4% are engaged, with; screw threads 44 innut members; G5 carried; by. and spaced outwardly from the, post. The nuts 45 may; be formed in,-. tegral with: thepost or on the ends of. a trans.- verse bar or plate 46 suitably secured; to the post,

From the foregoing the. operation of, the mechanlsm. should now be readily' understandable.

When it, is desired to vary the verticaf angularadjustment of guide 22" rotation of knob 38 will" release set screw 31, whereupon protractor 21 may be rotated, which rotation will, in turn, be imparted through shaft I9 to shank 2|, and hence to guide member 22. Obviously a relatively fine adjustment may be made after initial setting, by suitable rotation of knobs 43 to vary the relative position of screws 42 and hence arm 4|. When one screw 42 is backed away from the arm, the other may be turned to move the arlmto the desired extent.

From the foregoing it will now be seen there herein provided improved mechanism for the angular adjustment of a nail or pin guide in a vertical plane; which: accomplishes all the objects of this invention and has many advantages.

I claim:

1.- Ina mechanism of the character described. base; an upright post rising therefrom, a transverse shaft rotatably mounted at the upper end of; said post,v an elongated guide for a nail or the like fixed to an intermediate portion of said shaft and disposed above and extending transversely of said, shaft a protractor fixed to said shaft at one side of said post and coasting with a fixed mark carried by said post a hub rotatably. clamped. to said haft at the other side: of said post and carrying a radial arm and a' pair of axially aligned adjusting screws supported from said post and having their inner ends engageablc with opposite, faces ofsaid arm. v V f 2. The structureofclaizn I said post has a bifurcated upper end to; provide bearing ears, said shaft has spaced cylindrical portions journaledin said ears and; a flat-faced intermediate. portion and said uide: hasga flat-faced recess to engage said; intermediate portion of the shaft. v

In a mechanism; of the character described; a basa an upright post rising therefrom, and havin a bifurcated upp r e d. rmi pace bearing ears), a transverse shaft having asquare portion between spaced cylindrical; journal portions, the latter being rotatable sai ears, an lon ated uide. for a n il on the ke1.disn transversely above; said. Post. and having a dependin shank. with a rectangular notch in its lower end for detachable engagement with the quared portion of. said; sh a hub ota ab e an. outer end. of. one, of said. journal portion and carrying a radiall extending arrma set screw for clamping said; hub to. said one journal? portion;

s aoedn t, members carnidbz sa 'dpost and disposed on opposite, sides? off said arm, opposed adjustin a d clamping screws in: said not" members v-Ji-th their inner endsengageable with opposite sidcsjof' said arm and all protractor; fixed to the. other of. said journali portions and; coasting: with. a fixed, mark carried by said post.

4. In. a mechanism of the; chara'cte r described,, an. u right: post, transverse shaft, rqtatably mounted at, the upper end. of, said post, an elongated guide for nail or'thdlikegsaii'd guijde'beingj disposed transversely aboveisaidfpost; and fixed to said shaft; to move therewith, aprotractor fi d. to said shaft and co-acting withafilxedlmarkf carjrieol'v by said post a radial arm having one. end adjustabl-y fixed to saidshaft, and; a pair; of axially alined adjusting screws supported,- from said post and having their; inner ends, engageable oppositef aces; of the free emitportiont of-said arm.

Ina mechanism ofthe character described, an upright-supporting post at transverse: shaft-ro tatably mounted atthe top of said-r pest and care rying an elongated guide for a nail-"cr me 5 6 said guide being disposed transversely above said having their inner ends enga-seable with oppopost, means for efl'ecting an approximate adjustsite faces of the free end portion Of said arm.

MARION F. STEPHENS.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS 10 liiimber Name Date 2,226,708 Cleary Dec. 31, 1940 ment of said shaft and its guide, said means including a protractor fixed to said shaft and coacting with fixed mark carried by said post, and eflecting a fine adjustment of said guide, said last mentioned means inadial arm having end adjustably 

